Reprint  from  The  Lancet-Clinic, ‘  December  27,  1913. 


BEGINNING  AT  JERUSALEM. 

Does  the  Board  of  Administration  or  Do  the 
Attendant  Nurses  Administer  the 
Custody  of  the  Insane. 

BY  BAYARD  HOLMES, 

H 

CHICAGO.  • 

THE  interest  taken  in  the  case  of  Mendel  Beilis, 
in  Kiev,  Russia,  was  and  is  one  of  the  remark¬ 
able  incidents  of  the  century.  Thousands  of 
Russians  left  their  jobs  for  days  in  a  demonstration 
strike.  University  students  struck  for  weeks  in  the 
great  cities  and  in  the  capital  of  Russia. 

In  America,  hundreds  of  mass  meetings  were  held 
and  petitions  were  sent  to  our  government  to  use  any 
influence  possible  to  secure  justice  to  Beilis. 

As  a  people,  we  are  very  sensitive  to  injustice,  to 
cruelty  and  to  barbarism  in  remote  and  distant  places 
like  Russia,  China  and  India.  Not  many  years  ago, 
George  Kennan  wrote  up  for  us  the  terrible  condi¬ 
tion  of  the  Russian  prisons,  and  we  read  his  accounts 
in  our  thirty-five  cent  magazines  before  “muck-rake” 
had  become  a  verb  in  the  English  language.  It  is 
passing  strange  that  we  are  so  far-sighted  and  yet 
can  not  see  what  is  in  our  very  midst.  Our  own 
prisons -are  scandalously  managed,  and  yet,  with  all 
the  encouragement  of  an  avaricious  and  sensation 
mongering  press,  the  atrocities  of  Jackson,  Michigan, 
and  Sing  Sing,  N.  Y.,  aroused  only  the  slightest  blush 
of  apology  in  American  Christian  democrats. 

There  is  hardly  a  hamlet  in  the  United  States  that 
does  not  have  one  or  two  missionary  societies  collect¬ 
ing  money  to  send  civilizers  and  Christianizers  to  re¬ 
mote  and  oppressed  peoples,  and  no  college  in  our 
country  is  so  small  that  it  has  not  one  or  more  country- 
bred  or  prayerfully-educated  missionaries  in  heathen 
lands. 

We  are  eager  and  alert  to  remove  the  mote  from 


our  brother’s  eye,  but  the  beam  in  our  own  eye  gives 
us  no  concern.  We  are  ready  to  preach  salvation  and 
righteousness  to  all  the  world,  but  if  anyone  would 
have  salvation  and  righteousness  beginning  in  Jeru¬ 
salem  he  is  but  a  common  scold. 

There  is  at  the  junction  of  three  rivers  in  the 
garden  spot  of  our  country,  a  beautiful  and  highly 
civilized  city  that  has  made  itself  known  in  many 
ways.  In  every  mart  of  China  and  India,  as  well  as 
in  every  retail  business  house  and  shoe-shine  booth 
in  America  and  Europe,  this  city,  through  its  princes 
of  manufacture  and  commerce,  has  set  up  a  monu¬ 
ment  to  the  three  gods  of  modern  civilization — 
Righteousness,  Accuracy  and  Efficiency.  It  is  a  little 
self-recording  and  adding  machine.  A  nickel-plated 
mathematical  court  of  justice  that  can’t  be  bribed;  a 
brass  and  iron  jury  that  can’t  be  suborned. 

The  three  rivers  that  come  together  where  this 
beautiful  city  spreads  herself  out,  not  long  ago  united 
in  one  tremendous  assault  to  drown  her  out,  as  our 
fathers  would  have  said,  because,  though  contributing 
to  the  righteousness  of  all  the  earth,  she  had  allowed 
much  injustice  to  flourish  in  her  very  midst. 

On  a  beautiful  hilltop  overlooking  the  happy  homes 
of  this  city,  overlooking  busy  factories  surrounded 
by  charming  gardens,  overlooking  clubs,  hotels,  music 
halls  and  busy  streets,  stands,  in  architectural  pre¬ 
sumption,  one  of  the  bedlams  maintained  by  the 
richest  of  our  too  rich  States.  In  this  house  of  bolts, 
bars  and  restraint  are  confined  fifteen  hundred  insane 
citizens,  sick  of  an  unknown  and  unsought-for  dis¬ 
ease.  They  are  the  sons,  the  brothers,  the  fathers, 
or  they  are  the  daughters,  the  sisters  and  the  mothers 
of  the  most  active,  the  most  useful,  the  most  suc¬ 
cessful  and  often  the  richest  citizens  of  this  charming 
modern  missionary  city.  Here  they  are  confined, 
confined  with  no  attempt  to  cure ;  confined  by  law 
without  protection  by  the  provision  of  that  law  from 
ignorance,  cruelty  and  neglect. 

In  this  madhouse  there  was  confined  for  eight 
years  in  a  dungeon  (the  “strong”  room  in  the  ver¬ 
nacular  of  the  nurses  and  doctors),  a  man  whose 


*3  G  £ .  SL 
V\  ^  ^A- V 

only  crime  was  a  sickness  for  which  he  was  not  per¬ 
sonally  responsible,  with  no  light,  ho  bath,  no  de¬ 
cencies.  His  name  was  Okey  Lee. 

In  this  house  of  gloom  was  held  in  custody,  in 
squalor  and  filth  the  father  of  a  beautiful  society 
woman,  a  woman  sought  in  every  salon  on  two  con¬ 
tinents.  This  poor  man  was  left  in  drooling  filth  and 
neglected  attire  except  when  visited  by  one  of  his  tip¬ 
giving  family. 

The  inmates  in  this  neglected  asylum  are  under  the 
care  ostensibly  of  the  superintendent  (who  does  noth¬ 
ing  with  the  bedlamites  except  to  see  to  feeding  and 
housing)  and  two,  sometimes  three,  physicians,  one 
physician  for  each  500  lunatics.  The  salary  of  the 
assistant  superintendent  and  acting  physicians  is 
$75.00  per  month.  The  salary  of  the  farmer  is  $125.00 
per  month. 

The  superintendent  has  many  duties  and  must 
decide  matters  every  few  minutes  for  a  family  of 
nearly  two  thousand.  He  has  no  time  or  interest  in  ' 
the  diseases  that  bring  fifteen  hundred  lunatics  into 
his  charge,  and  he  is  unmindful  or  careless  of  any 
possibilities  of  cure.  But  he  is  thrifty.  He,  at  one 
time,  to  save  the  State,  ordered  a  cow  with  a  large 
abscess  on  her  rump,  killed  and  turned  over  to  the 
butcher  to  be  fed  to  the  patients  and  attendants,  and 
because  the  institution  blacksmith  protested,  the  black¬ 
smith  was  discharged  from  the  State  service  for  in¬ 
subordination  ! 

This  superintendent  is  much  interested  in  astron¬ 
omy, ‘also  in  hen  culture.  He  has  devoted  much  time, 

1  energy  and  cunning  to  his  hennery,  which  is  the  show 

place  of  this  State  Hospital.  When  psychiatrists  from 
New  Zealand  visit  this  proud  monument  of  State 
i  charity  and  State  civilization,  does  the  superintendent 

show  the  visitors  to  his  laboratories  equipped  for 
bacteriologic,  hematologic  and  serologic  researches  ? 
Does  he  show  them  his  baths  for  disturbed  patients 
and  his  outdoor  facilities  for  the  manic-depressive 
and  the  tuberculous?  Does  he  conduct  them  to  the 
occupational  training  rooms  or  to  the  outdoor  re¬ 
education  classes?  Does  he  show  his  clinical  charts 

3 


and  case  histories,  his  weight  charts,  his  sleep  charts, 
his  blood  corpuscle  charts?  No,  none  of  these.  He 
unrolls  his  telescope  and  points  it  to  a  red  spot  on 
the  gibbosity  of  Jupiter,  or  he  brings  out  the  pedigree 
of  his  registered  hens  and  roosters,  and  shows  painted 
photographs  of  his  chickens  in  every  stage  of  plumage. 
His  charts  show  only  the  number  of  eggs,  the  weight 
of  birds  and  the  expense  to  the  State  of  each  pound 
of  poultry,  and  each  dozen  of  eggs.  What  is  done 
with  this  poultry  and  these  eggs?  Are  the  eggs  used 
to  feed  the  starving,  excited,  manic-depressive  cases 
as  they  lie  in  the  tubs  of  running  water?  Are  these 
eggs  forced  into  their  stomach  through  nasal  tubes? 
Are  the  broilers  served  on  Sundays  to  the  conva¬ 
lescents  ?  Or,  mayhap  are  they  sold  to  the  dis¬ 
criminating  citizens  of  our  beautiful  city  to  be  dis¬ 
placed  by  cold-storage  stuff? 

This  beautiful  hennery  is  the  pride  of  the  hospital 
superintendent,  and  is  in  charge  of  a  college  professor 
at  salary  unknown  to  the  writer,  but  doubtless  satis¬ 
factory  to  the  Board  of  Administration  and  pub¬ 
lished  in  their  annual  or  bi-annual  report  to  the  legis- 
ture  elected  by  the  friends  of  the  insane. 

The  charming  community  in  which  this  State  hos¬ 
pital  is  located  is  full  of  churches,  and  the  young 
people  in  the  churches  are  full  of  charitable  activities. 
They  read  of  the  burning  of  widows  in  India  with 
horror  and  give  their  mites  to  send  missionaries  there. 
Some  of  them  actually  educate  themselves,  or  are 
educating  themselves  for  missionaries,  and  yet  they 
have  never  heard  of  the  atrocities  committed  in  the 
Greek  temple-like  Bedlam  on  the  hill  above  them.  For 
eight  years  poor  Okey  Lee  heard  the  church  bells  ring 
“Peace  on  Earth”  and  “Brotherhood  of  man,”  and 
yet  all  that  time  he  was  never  visited  by  one  of  the 
“little  brothers  of  the  poor.”  Better  was  it  for  the 
lepers  of  Assisi  than  for  the  wards  of  the  too  rich 
State  and  the  guests  of  the  too  cultured  and  charm¬ 
ing  city  at  the  junction  of  the  three  rich  river  valleys. 

Once  an  humble  son  of  that  most  envied  city,  a 
city  so  rich  that  it  can  call  the  builder  of  the  Panama 
Canal  at  a  doubled  salary  to  come  and  mayor  it, 

4 


a  son  of  that  city,  by  chance,  became,  at  a  salary  of 
$75.00  a  month,  assistant  physician  in  this  asylum 
for  the  insane.  He  found  the  most  desperate  con¬ 
ditions.  He  brought  to  the  notice  of  the  superin¬ 
tendent  and  the  Board  of  Administration  the  most 
revolting  atrocities  committed  by  the  nurse  attendants, 
both  of  active  cruelty  and  passive  neglect.  He  ordered 
baths,  surgical  dressings  to  bed-sores,  enemas  to  suf¬ 
fering  maniacs  who  had  been  doped  for  days,  removal 
from  restraint,  exercise  in  the  open,  and  general 
cleaning  up  and  getting  busy. 

The  attendant  nurses  saw  that  they  were  up  against 
a  stiff  proposition.  It  was  a  case  either  of  work  and 
earn  their  wages,  or  fight  and  remove  the  doctor. 
Many  of  them  were  old  stagers  and  had  lived  in  the 
State  hospitals  longer  than  anyone  else.  They  held 
meetings  and  put  the  screws  on  the  superintendent 
and  some  members  of  the  Board,  of  Administration. 
They  openly  rebelled.  The  assistant  physician  dis¬ 
charged  them  at  once.  They  were  tried  before  the 
alienist  of  the  board  and  reinstated  and  the  physician 
let  go. 

As  citizens,  we  are  interested  in  the  efficiency  of 
our  State  institutions.  As  physicians,  we  are  jealous 
of  our  profession’s  traditions.  If  a  physician  is  at 
the  head  of  such  a  disgraceful  and  atrocious  institu¬ 
tion,  he  should  be  deprived  of  his  professional  stand¬ 
ing  by  being  expelled  from  all  medical  fellowship. 
So  should  any  young,  starving  doctor  who  remains 
in  the  institution  where  such  atrocities  are  frequent 
and  such  neglect  constant.  If  the  uneducated,  in¬ 
human  and  vicious  band  of  tramp  nurse  attendants 
can  secure  the  discharge  of  a  physician  because  he 
is  determined  to  bring  order  and  cleanliness  out  of 
rowdyism  and  filth,  then  it  is  time  for  the  medical 
profession  to  boycott  the  Board  of  Administration 
and  prevent  any  medical  man  in  good  standing  from 
entering  the  State  service  while  these  conditions  pre¬ 
vail. 

The  abortionist  has  often  at  least  humanity  and 
pity  on  his  side.  The  unfortunate  girl  claims  his 
sympathy  in  her  desperation  and  threatened  degrada- 

5 


tion,  but  the  hospital  physician  who  permits  the  every¬ 
day  abuses  and  the  frequent  atrocities  which  are  per¬ 
petrated  in  the  prison-like  asylums  of  our  rich  States 
is  either  a  coward  or  a  criminal  of  the  basest  instincts. 

There  is  hope  only  in  the  interest  and  activity  of 
the  friends  of  the  insane.  They  should  organize  in 
every  town  in  the  State.  One  out  of  every  500  are 
now  in  the  asylums  and  madhouses.  Fifteen  thou¬ 
sand  young  -folks  of  about  high  school  age  go  each 
year  into  these  bedlams  never  to  come  out.  Most  of 
them  die  of  tuberculosis  or  bed-sores  in  revolting 
filth.  Some  of  them  become  the  drudges  to  fetch  and 
carry  about  the  place. 

The  friends  of  the  insane  should  organize  and 
demand  of  the  Board  of  Administration,  above  all 
things,  a  visitor  with  keys  to  all  wards  and  unre¬ 
strained  admission,  day  and  night.  They  should  de¬ 
mand  liberal  provisions  for  research  and  adequate  pay 
for  medical  service.  They  should  demand  that  all 
meetings  of  the  Board  of  Administration  be  open  to 
their  representatives. 

In  the  old  days  the  local  political  boss  had  control 
of  the  asylum  in  his  district.  He  was  approachable 
and  human.  He  certainly  could  be  reached,  but  this 
safety-brake  to  abuses  is  gone.  The  Board  of  Con¬ 
trol  is  a  remote,  impersonal  and  often  cruel  entity. 
It  has  power  without  sympathy,  without  mercy, 
like  the  corporation  without  the  rump  to  kick,  or  the 
soul  to  damn. 


PITY,  HAVE  PITY! 

Oh,  for  a  gleam  of  the  sun,  a  taste  of  the  sweet  air's  breath,  g 

Keeper  of  man  in  this  hole  of  darkness,  and  foulness,  and 
death : 

Even  the  hounds  of  hell  would  pray  to  escape  his  fate, 

You  who  can  rescue,  and  save,  pity,  ere  it  is  too  late. 

Lift  up  your  voices  and  plead;  shout  it  from  mountain  to  sea, 

Ever  the  world-old  story,  for  the  prisoned  slave  to  be  free, 

Ever  the  human  martyr,  in  a  suffering  Okey  Lee. 

[e.  l.  s.] 


6 


1 


* 


i 


3  0112  062039091 


